Organization Name:  FOUNDATION SURGERY AFFILIATES OF S.W. HOUSTON LLC


Practice Location:
8111 SOUTHWEST FWY  HOUSTON, TX 77074 US
Tel: 713-272-6300  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	TX	007215

Other Provider Identifiers:

Issuer	Number	State	Type
FACILITY LICENSE	007215	TX	01
DPS	20117145	TX	01
PHARMACY LICENSE	20526	TX	01
THCIC	721500		01
MEDICARE	ASC091	TX	01
DEA	BD 6933558		01
	0879868-01	TX	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin